Seizures Flashcards

(54 cards)

1
Q

What is the definition of seizures?

A

Episodes of abnormal neurological function caused by abnormal electrical charges in the brain

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2
Q

Abnormal electrical activity in the brain can cause:

A
  • Strange sensations
  • Strong emotions
  • Convulsions and spasms
  • Loss of consciousness
  • Unusual behaviours
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3
Q

What is the WHO definition of epilepsy?

A

A chronic disorder characterised by recurring seizures, diagnosed after two (unprovoked) seizures

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4
Q

What are the causes of seizure?

A
Epileptic disorders
Unknown ideology 
Underlying disorders 
- Metabolic disorders 
- Cerebral tumours
- HI
- Intracranial infections
- Hypo/hyperglycaemia
- Hypoxia
- Drugs/alcohol
- Intracranial haemorrhage
- Stroke
- Birth trauma
- Stress/anxiety
- Sleep disorders
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5
Q

Name the points of the acronym AEIOUTIPS

A
Arrhythmia/alcohol/acidosis
Environmental/envenomation/epilepsy
Infection
Overdose
Uraemia (kidney failure)
Trauma/toxins
Insulin
Psychogenic
Shock/sepsis
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6
Q

What are the side effects of seizures?

A
  • Headache
  • Dizziness
  • Light-headedness
  • Confusion
  • Double/blurry vision
  • Poor coordination/balance
  • Unsteady gait
  • Nausea
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7
Q

Name the stages of seizure

A

Beginning, ictal phase, and post-ictal phase

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8
Q

What (generally) happens in the beginning stage of a seizure?

A

Aura (strange taste or small), though not all pts have an aura

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9
Q

What is the ictal phase?

A

Period of time from the first symptoms (including the aura) to the end of seizure activity

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10
Q

What is the post-ictal phase?

A

Recovery phase

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11
Q

Are auras considered part of a seizure?

A

Yes

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12
Q

True or false: a seizure may start with loss of consciousness or change in awareness

A

True

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13
Q

What is the term for an aura occurring alone without change in awareness?

A

Focal seizure

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14
Q

What are some awareness/sensory/emotional/thought changes before a seizure?

A
  • Smells
  • Tastes
  • Sounds
  • Deja vu
  • Strange feelings
  • Fear/panic
  • Vision loss/blur
  • Racing thoughts
  • Pleasant feelings
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15
Q

What are some physical changes before a seizure?

A
  • Dizzy or light-headed
  • Headache
  • Nausea or ‘stomach rising’ feeling
  • Numbness or tingling
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16
Q

True or false: some physical symptoms may be after-effects and not related to the ictal phase

A

True

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17
Q

What are some symptoms during a seizure?

A
Loss of awareness
Confused, 'feeling spacey' 
Forgetfulness/memory lapses
Distracted/daydreaming
Loss of consciousness
Hearing loss/altered auditory sense
Vision loss/altered
Unusual tastes/smells
Visual hallucinations 
Numbness/tingling/electric shock feelings
Out of body sensations 
Deja vu, jamais vu
Body parts feel or look different
Panic/fear/impending doom
Pleasant feelings
Difficulty speaking
Unable to swallow/drooling
Repeated blinking/movement of eyes/stare
Lack of movement or muscle tone 
Tremors/twitching/jerking movements (may occur in one or more places, may begin in one area then spread, may be whole body)
Rigid or tense muscles
Automatisms (repeated non-purposeful movements)
Repeated purposeful movements (may continue previous activity)
Convulsions
Incontinence (urine incontinence common)
Sweating
Pale or flushed
Pupil dilation
Teeth clenching/biting tongue
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18
Q

How long is the post-ictal phase?

A

May be immediate, minutes, or hours

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19
Q

Is the post-ictal phase effected by seizure type/affected brain region?

A

Yes

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20
Q

What are some symptoms that may follow a seizure?

A
Slow to respond
Sleepy
Confused
Memory loss
Difficulty talking or writing
Feeling dizzy/light-headed/'fuzzy'
Depressed/sad/upset
Scared/anxious
Frustrated/embarrassed/ashamed
Injuries from ictal phase
Headache/other pains
Nausea
Thirst
General one-sided weakness
Urge to use bathroom/incontinence
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21
Q

What are the two categories of seizure?

A

Generalised and focal

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22
Q

What is the definition of a generalised seizure?

A

Occurs across both hemispheres of the brain

23
Q

What is the definition of a focal seizure?

A

Occurs in one area of the brain

24
Q

What are the two subsets of generalised seizures?

A

Convulsive (tonic/clonic) and non-convulsive (absent)

25
Can focal seizures become generalised seizures?
Yes
26
Focal seizures were previously named...
Partial/simple
27
Name the subtypes of convulsive seizures
``` Tonic clonic Tonic Clonic Atonic Myoclonic ```
28
What is the common duration of a tonic clonic seizure?
1 to 3 minutes
29
What commonly occurs in a tonic clonic seizure?
``` Loss of consciousness Body becomes stiff (tonic) Jerking movements (clonic) Person may bite tongue or produce excess saliva Loss of bladder control Headache Deep sleep Confusion ```
30
What is characteristic of a tonic seizure?
Stiffening of the body (without jerking)
31
What is characteristic of a clonic seizure?
Bilateral rhythmic jerking of limbs (rare)
32
What is characteristic of an atonic seizure?
Sudden loss of muscle strength (person falls forward)
33
True or false: recovery after atonic seizures tends to be quite slow
False
34
Atonic seizures carry the risk of...
Injuries to the face/head.
35
What is characteristic of myoclonic seizures?
Jerking movements, mostly in the head and upper limbs
36
Myoclonic seizures are linked to...
Sleep patterns
37
Describe a typical absence seizure
- Pause in activity with a blank stare - Occurs frequently - Duration 5-10 seconds - Rapid blinking/eye deviation
38
What can trigger a typical absence seizure?
Hyperventilation
39
Describe an atypical absence seizure
- Begins and ends gradually - Duration >10 seconds - Eye blinking/lip movements
40
Can atypical absence seizures be triggered by hyperventilation?
No
41
What are some motor signs of focal seizures?
``` Dysphasic Atonic Weakness Jerks/twitching Todd's paresis (temporary paralysis, often post seizure) ```
42
What are some non-motor aspects of focal seizures?
``` Olfactory Visual Somatosensory Gustatory Auditory Autonomic Psychic Automatisms ```
43
What is the two definitions of status epilepticus?
- Seizure activity lasting longer than five minutes | - Seizures less than 20 minutes apart with or without recovery (clustering)
44
Status epilepticus is more common in which population groups?
Extremes of age and the mentally handicapped
45
What is the concern with status epilepticus?
Continued seizure activity contributes to neuronal damage
46
What is neuronal damage from continued seizure activity exacerbated by?
- Hypoxia - Hypoglycaemia - Lactic acidosis - Hyperpyrexia
47
What is a common issue with anti-convulsant medication?
Non-compliance
48
In which phase is it appropriate to give O2?
Post-ictal
49
What is the seizure-specific indication for midazolam?
Generalised or focal seizure with GCS less than or equal to 12
50
What are the contraindications for midazolam?
KSAR
51
What are the precautions for midazolam?
- Reduce dose for elderly/chronic renal failure/CHF/shock - Myesthenia gravis (autoimmune disease that effects muscles) - Multiple sclerosis
52
What are the side effects of midazolam?
Hypotension and respiratory depression
53
What is the adult dosage of midazolam?
5mg/1mL, 5mg every 10 minutes with a max of 20mg
54
What is the paediatric dosage of midazolam?
200mcg/kg, max 5mg in one dose, every 10 minutes with a total max of 10mg